Gold Star Community Health Center, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GOLD STAR COMMUNITY HEALTH CENTER, INC.

Practice address

6343 Vineland Ave
N Hollywood, CA 91606-3721

Phone

(747) 877-2789

NPI assigned

Jun 14, 2021

Last updated

Jun 14, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ella Undzhyan

Title

Ceo

Phone

(747) 877-2788

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124696349. Details of each certification follow.

• CCN 054679 Community mental health center · Active · Name & address match · Details

Community mental health center certification: CCN 054679

Legal name

GOLD STAR COMMUNITY HEALTH CENTER, INC

Certification status

Active

Provider type (POS)

Community mental health center

Participating since

Jun 22, 2022

Last certification

Jun 22, 2022

Ownership / control type

For profit – individual

Facility address

6343 Vineland Avenue
N Hollywood, CA 91606

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Arman Voskerchyan

  • Preferred Provider Organization
  • Valley Village, CA
  • NPI 1790060804
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1124696349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6343 VINELAND AVE",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063721",
            "telephone_number": "747-877-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6343 VINELAND AVE",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063721",
            "telephone_number": "747-877-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD STAR COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "UNDZHYAN",
        "authorized_official_first_name": "ELLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-877-2788"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in N Hollywood, CA
• Providers in N Hollywood, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.